Sticker Shock
Birth control prices are skyrocketing—
and that’s just one way the current federal
administration is making it harder for
women to obtain contraception

By Allison Stevens

When Emory University incoming
senior Nora Kleinman discovered
last winter that the cost of
NuvaRing, her preferred method
of birth control, had nearly doubled
at her campus health center—
going from $27 to $44 a month—she was forced to make
a quick decision: find a way to come up with an extra $204
a year or switch to her parents’ insurance plan, and thus
give up the privacy she had enjoyed at the student health
clinic. “Everybody’s fairly irritated about it,” says
Kleinman. “Myself and so many other women I know
were depending on health services at universities for
cheap and affordable contraception.”

Millions of women who purchase contraceptives at student
and community health clinics across the country
have seen prices go from about $10 a month to anywhere
between $30 and $50. Such out-of-reach prices are putting
intense financial stress on women who can’t afford to
pay retail for birth control. And the pressure goes beyond
the individual level: Some family planning clinics serving
low-income women may be forced to shut down if prices
aren’t soon reduced, leaving poor women with even fewer
resources to determine the number and spacing of their
children.

Among college undergraduate women, some 3 million
of them (39 percent) use oral contraceptives, while others
use NuvaRing, the contraceptive patch and other forms of
birth control, according to the American College Health
Association. Those who cannot find a way to come up
with more cash are being forced to switch to an alternative
make or method of birth control, says Mary Hoban, a director
of the association’s National College Assessment
Program. Some university health centers and clinics have
now even stopped carrying devices such as NuvaRing—a
popular method which delivers contraceptive hormones
through a vaginal insert—because of their increased price.

For many women, changing birth control methods or
makes is not easy. NuvaRing and the patch have no generic
alternatives, and women are often reluctant to switch
brands of oral contraceptives after finding a good fit without
undesirable side effects.

The soaring costs are the result of an obscure provision in
the Deficit Reduction Act of 2005 that stripped away a long standing incentive encouraging drug
companies to provide steeply discounted
birth control to certain low-cost
health-care providers. The law took effect
in January, forcing many health
clinics across the country to ratchet up
their prices. Some temporarily defrayed
costs by stockpiling drugs before
the law took effect, but those
reserves are rapidly depleting.

Pro-choice advocates see the change
as part of a broader attack on contraception
access. “It’s a horror,” says Rep.
Carolyn Maloney (D-N.Y.), who has
led the fight in Congress to preserve
access to birth control. She points to
U.S. pharmacists refusing for personal
or religious reasons to fill birth control
prescriptions, and four states—
Arkansas, Georgia, South Dakota and
Mississippi—enacting laws allowing
them to do so. She also cites a crackdown
on birth control by anti-choice
Republicans in Congress and the
White House. In 2002, the Department
of Defense approved a plan to
make emergency contraception (EC)
available at all military treatment facilities,
but political appointees later reversed
the decision. And in 2004, the
Department of Justice did not include
EC in its recommendations for treating
sexual-assault victims—an omission
Maloney calls intentional.

In every year he has held office,
Bush has sought to freeze Title X
funding, which pays basic operating
costs at more than 4,500 family planning
clinics serving millions of low-income
women. Congress nonetheless
approved slight increases in Bush’s
first five years, but those were not
enough to keep up with inflation. In
fact, taking inflation into account, Title
X funding is now 61 percent lower
than it was in 1980, according to
the National Family Planning and Reproductive Health Association.
Had funding levels merely kept up
with inflation, clinics would now receive
more than $725 million a year;
instead, Bush wants to freeze Title X
funds at last year’s $283 million level.

Meanwhile, anti-choice Republicans
have found pots of money to
pour into abstinence-only programs,
which gag educators from discussing
contraception outside the context of
its failure rate. Critics have long
questioned the efficacy of these programs,
and they got a clear answer in
an April report conducted on behalf
of the Department of Health and
Human Services: It showed that abstinence-
only education does not
prevent young people from having
sex, nor does it influence the number
of sexual partners they have or the
age they first engage in intercourse.
Still, federal funding for abstinenceonly
has exploded from $80 million
in fiscal 2001 to $176 million, according
to NARAL Pro-Choice America.

What has shocked reproductiverights
advocates is that Democrats in
a House Appropriations subcommittee
voted to approve $28 million in
additional funding for communitybased
abstinence-only education. In
turn, the subcommittee also approved
a $28 million hike in Title X
family-planning funding. But the advocates
thought the compromise
both unnecessary and wrong: “There
is no other way to describe this concession
but as shameful,” reads a
statement from William Smith, vice
president for public policy at the Sexuality
Information and Education
Council of the United States.

Other Democrats continue to push
a pro-family-planning agenda, however.
House Speaker Nancy Pelosi
wants to change the language in the Deficit Reduction Act to bring down
the price of birth control at health
clinics, while other rank-and-file
Democrats are promoting bills to require
that the Justice Department
mention EC in sexual-assault treatment
recommendations and the Defense
Department make EC available
at all military treatment facilities.

And they’re counting on support
from Senate Majority Leader Harry
Reid (D-Nev.) and House Rules
Chair Louise Slaughter (D-N.Y.) to
push through the Prevention First
Act, which would ease access to contraception,
require insurers to cover
birth control, increase funding for
comprehensive sex education and ensure
that women can get their birth
control prescriptions filled. The prevention
push is also playing out in the
states: Between January and June 1,
state legislators introduced 151 measures
aimed at preventing unintended
pregnancy, and eight states passed
pregnancy-prevention laws.

Still, with a majority of federal
lawmakers opposed to access to full
reproductive health care, and a president
who bends to the will of antichoice
leaders, progress is slowgoing,
says Mary Jane Gallagher,
president of the National Family
Planning and Reproductive Health
Association. She notes the huge disconnect
between a vast majority of
voters who support unfettered access
to birth control, and their government
representatives who are unduly
influenced by a small but powerful
faction of conservatives.

“We’re not there yet,” Gallagher
says. “Clearly, the conservative right
made some serious inroads into policymakers
and so it’s not going to happen
overnight.”